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Trauma, revisited: As the Central Coast's doctors and nurses face another COVID-19 surge, they're still grappling with the last one's impacts

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Health care workers are no strangers to witnessing suffering and death. But COVID-19 was different. The professionals not only treated their patients, they also offered company in the absence of family and friends. French Hospital telemetry nurse Tamara Astorga said it was hard to see her patients be so secluded.

"In order to support people, you have to put them on so much oxygen. It's hard to breathe, you can hardly talk," she said. "And the other thing is that we have to isolate those people. They're just alone in a room. There was a striking loneliness to the isolation of it."

Brittany Martinez, an ICU nurse at French Hospital, said "relentless" is the word that best sums up her experience.

"Typically I think that we are able to get through traumatic experiences in the ICU because there's usually an ebb and flow," she said. "We have periods that are hard, but then periods that have a lot more success stories and people do better. ... But I think throughout the course of the year, it sort of slowly built up."

The 2020-21 winter surge months were the hardest for Martinez.

"A lot of COVID patients, when they get sick, they are with us for months at a time," she said. "But when you're critically ill like that, the issues sort of compound, they pile on top of each other, until eventually the person you're looking at is sort of a shell of who they once were. ... It was very defeating, and I felt very helpless."

For Dr. Alicia Gonzalez, medical director of Marian Regional Medical Center's Emergency Department, one of the hardest parts of COVID-19 is not being able to escape work outside of the hospital.

"It was so much more than just seeing sick people," she said. "It was arguments about masking or vaccination or 'is this even real?' And I think for our staff, the reality of having to see what we saw at work, and then leave the building into communities where maybe people questioned that it was real, or if we were telling the truth—that took a way bigger emotional toll on all of us."

As the world began to reopen in the spring, bringing some normalcy back to average people's lives, health care workers everywhere were still stuck processing the horrors they endured and the trauma they now live with. And as the number of hospitalized patients is now ticking back up in SLO and Santa Barbara counties, Central Coast nurses, doctors, and other health care workers are bracing to do it all over again. Nurses and doctors say getting through it requires leaning on mental health resources—and each other.

Prioritizing mental health

From June to September 2020, Mental Health America hosted a survey of health care workers to see how COVID-19 was affecting them.

"Ninety three percent of health care workers were experiencing stress, 86 percent reported experiencing anxiety, 77 percent reported frustration, 76 percent reported exhaustion and burnout, and 75 percent said they were overwhelmed," the results said.

The majority of workers also reported feeling emotionally exhausted, having trouble sleeping, physical exhaustion, and work-related dread.

COVID-19, AGAIN Central Coast health care workers at places such as French Hospital Medical Center deal with a new influx of COVID-19 patients. - COVER IMAGE COURTESY OF DIGNITY HEALTH
  • Cover Image Courtesy Of Dignity Health
  • COVID-19, AGAIN Central Coast health care workers at places such as French Hospital Medical Center deal with a new influx of COVID-19 patients.

Because of the nature of health care workers' jobs, hospitals already had a slew of mental health resources available to employees pre-pandemic. Dignity Health, Lompoc Valley Medical Center, and Cottage Health all have an employee assistance program and counseling options for staff. But what health care workers were experiencing with COVID-19 required more.

Lompoc Valley Medical Center Chief of Quality Improvement, Risk Management, and Infection Prevention Melissa DeBacker, MSN, leads the Healing the Healers initiative, which stemmed from the hospital's COVID-19 task force. The hospital invited a local licensed therapist who was available to talk with any employee who needed to. It was completely confidential and free to all staff.

DeBacker said, from her observations, health care workers leaned on these services more after the worst surge had ended, rather than in the thick of it.

"You don't realize in the moment: Your adrenaline's going, you're doing what you need to do," she said. "Later on, some of our staff started struggling with being able to sleep; started having scenarios repeating that upset them. It was later that people began understanding, 'I might need to talk to somebody.' That's absolutely normal."

It's still here

As cases start to flare up again and hospitalizations increase, a lot of the trauma from the past year and a half is coming back to the surface for health care workers.

"You become burnt out, and it takes time to mentally and emotionally recover from that," French Hospital ICU nurse Martinez said. "So I think now that cases are surging again, it's definitely scary, but it's also just disheartening. It's hard not to just continue to feel like the burnout hasn't really gone away."

And with the vaccine widely available, nurses and doctors said it adds a new layer of frustration that people are still ending up in the ICU and dying when these outcomes are now largely preventable.

"It's such a difficult debate because most of these people just want more information, but how long are you going to wait?" French hospital nurse Astorga said. "It's an interesting stretch in compassion that we hadn't really had to deal with prior to COVID either."

But at the end of the day, Astorga continued, being a health care worker is about staying neutral and doing everything you can to care for the human in front of you.

Dr. Lynn Fitzgibbons, an infectious disease specialist at Cottage Hospital in Santa Barbara, said this mindset is crucial to getting through it all, day after day.

"A sick patient is a sick patient, and we're tasked to provide care," she said. "The job is caring for the person in front of us, while in parallel, making sure that we do whatever we can to prevent that next sick patient from coming in next week. ... At the end of the day, no one deserves to have this disease." Δ

Reach Staff Writer Malea Martin at mmartin@newtimesslo.com.

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